Eastman Dental’s Successful Teledentistry Program Expanding
“Through the simple technology of teledentistry,” said Sean McLaren, DDS, chair, Eastman Dental’s Pediatric Dentistry Department, “we are changing and improving the lives of underserved children.”
When Eastman Dental launched a pilot teledentistry program for children in the rural areas of New York State 14 years ago, pediatric dentists were able to see patients remotely and determine if a child needed to come in for treatment. At the time, only 15 percent of the patients who needed treatment followed through. Over the years, the program has proven to be effective, increasing the number of children who get follow up operating room treatment to 93 percent. To date, it’s served nearly 900 preschoolers, children of migrant workers, and families living in rural areas or in poverty.
This extensive experience with teledentistry has led Eastman Dental to expand the program’s reach into the Watertown area. It’s also become an opportunity to co-host the first national teledentistry conference this summer, which will help other organizations set up similar programs.
Eastman Dental’s teledentistry program began 14 years ago, thanks to public and private funding, when 500 preschool children in various inner city day care centers were first examined to see if teledentistry was useful in identifying at risk children and preventing extensive treatment down the road. It proved to be very useful.
Almost half of the screened children had never been to a dentist, and more than 40 percent of them had cavities.
“Intervention at an early age is critical,” said Dorota Kopycka-Kedzierawski, DDS, MPH, who led the initial research project and is a co-author of a paper recently accepted in Health Affairs. “Teledentistry can help more children by preventing and detecting early childhood tooth decay and finding them a dental home.”
Over the last several years, the program has grown tremendously. Working primarily with the Finger Lakes Community and Migrant Health, Eastman’s teledentistry program is now a live video where children are screened in real time at the health center they are used to going.
With an Internet connection, a web cam, and an intra-oral camera, a community health center can provide access to pediatric dental care at Eastman.
“Sadly, one in three preschoolers has tooth decay,” Dr. McLaren explained. “The largest population affected are families with low income, racial and ethnic minorities, and children with disabilities.”
They experience many barriers to getting care. And for families living in rural areas without access to reliable transportation, it can be extremely difficult to see a dentist on a regular basis, making pediatric dental disease an even bigger challenge.
Children and families who don’t have access to teledentistry have very few options for care. Many end up in the emergency room at their local hospital. More often than not, these hospitals don’t have dentists on staff, and certainly not pediatric dentists.
Or, a case worker would arrange for transportation for a consult at Eastman, and an interpreter if needed. Then, the child, parent, interpreter and case worker would drive up to 2 hours one way for a consult by an Eastman Dental pediatric dentist. In about half the cases, the child would have extensive decay—typically 10 to 20 cavities--and need to undergo treatment in the operating room at a later date. For the other cases, the child would still need to come back for treatment in one or a handful of visits.
“Teledentistry eliminates that first step,” explained Dr. McLaren. “An initial teledentistry consultation allows Eastman Dental’s pediatric dentists to see what oral care may be needed, relieves the burden of family travel, and helps us better prepare for a first face-to-face appointment.”
Dr. McLaren can see the patient and the parent, and they can see him. They all talk and the dentist gets a sense of whether the young patient seems scared or is overly rambunctious. The child’s behavior helps Dr. McLaren assess if he or she would be a good candidate for nitrous oxide or conscious sedation. The patient gets comfortable, too, and sees that Dr. McLaren is a nice guy, even kind of funny, and this whole experience may not be so bad.
Not only does the teledentistry experience increase the comfort of the anxious child and sometimes parents, but it saves a lot of time, as well as taxpayer dollars.
To help more children, Eastman Dental recently expanded their outreach to include those living in the Watertown area. They are working with North Country Federally Qualified Health Center, which gets support from the federal government and provides services to anyone, regardless of ability to pay.
Eastman and the American Teledentistry Association are teaming up on June 7 and 8 to host the first ever national Teledentistry Conference. The program will host several experts to cover regulatory and operational challenges, telehealth law, state legislation, a dental insurer, a panel of Eastman Institute and Finger Lakes Community and Migrant Health providers, as well as the keynote speaker, Paul Glassman, DDS, MA, MBA professor and director of Community Oral Health and director of the Pacific Center for Special Care at the University of the Pacific School of Dentistry in San Francisco.
“The potential for teledentistry is huge,” said Eli Eliav, DMD, PhD, director, Eastman Institute for Oral Health and vice dean of Oral Health for the University of Rochester’s School of Medicine and Dentistry. “It can benefit such a broad spectrum of people, including children, of course, as well as those with developmental disabilities, older patients who aren’t mobile, incarcerated populations, and those who just live too far away from a dentist.”
For more information about Eastman’s Teledentistry Program or the Teledentistry Conference, please contact Dr. Sean McLaren at firstname.lastname@example.org.
Karen Black |